Coronary Sinus Dissection during Left Ventricular Pacing Electrode Implantation

Masataka Yoda, MD,1 Bert Hansky, MD,2 Reiner Koerfer, MD,PhD,2 and Kazutomo Minami, MD,PhD1

Coronary sinus (CS) dissection during biventricular pacing electrode implantation is a complication that rarely develops. A 71-year-old female with recurrent ventricular tachycardia, heart decompensation, and poor left ventricular function because of dilated cardiomyopathy was admitted for the implantation of a cardioverter-defibrillator for biventricular pacing. During the operation, we experienced a CS dissection with hematoma in the left ventricle wall while introducing the guidance catheter into the CS. However, the pacing lead was successfully implanted into the posterolateral vein using the 呰ver-the-wireモ??technique. The postoperative electrocardiogram showed a decreased QRS; meanwhile, the echocardiography revealed dimensional reduction and functional improvement of the left ventricle. (Ann Thorac Cardiovasc Surg 2007; 13: 275-277)

Key words: coronary sinus, left ventricular pacing, dissection

1Department of Cardiovascular Surgery, Nihon University Hospital, Tokyo, Japan, and 2Department of Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westphalia, University of Bochum, Bad Oeynhausen, Germany

Received September 11, 2006; accepted for publication December 25, 2006
Address reprint requests to Masataka Yoda, MD: Department of Cardiovascular Surgery, Nihon University Hospital, 30–1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo 173–8610, Japan.